Therapy Should Not Focus On Symptoms

Notes on Alice from her new counselor:

Alice’s father drank heavily and used his belt on her often. She remembers being terrified of him when she was a child. She describes her mom—an unstable woman who had a psychiatric history of her own—as psychologically abusive. “Dad’s anger and abuse was mostly predictable. I stayed clear of him as much as possible. Mom’s moods were unpredictable. One minute she could be showing me how to how to bake cookies, but then turn on me saying I was dumb and she wished she had never had me. It seems like I grew up always confused and afraid. Home was like a torture chamber.” More than thirty years after these repetitive disturbing childhood experiences, Alice has been a client in psychiatric counseling with medications, although without much success. She eventually quit her meds and began treatment with a series of psychological counselors, none of whom had much success with her.

She still has nightmares about her early home life. She shows symptoms of post-traumatic stress disorder along with unresolved anxieties caused by fear of abandonment. She complains of issues in areas of anger, anxiety, and depression, and shows pessimism and marked sensitivity in relating to life and people. She cannot handle criticism from others, and takes it as a personal attack and sign that she is incompetent and worthless. She has a long history of alcohol and drug abuse. “Nothing in life gives me the relief and pleasure I get from booze and drugs. I knew they didn’t mix well with my meds, so I quit taking the meds and the shrink who was prescribing them. Crazy, huh?”

During adolescence and early adulthood, Alice developed a strong indifference to her health and survival. To put it bluntly, she didn’t care if she lived or died—a hallmark of subtle suicide. Drugs and promiscuity became the major players in her life. Although she never went to jail, she was routinely involved in drunk and disorderly episodes. Remarkably, she avoided major setbacks for many years. Although she never tried to kill herself, Alice is intensely ambivalent about living. She has taken many risks and rolled the dice many times in her life and never seems to care what the outcome might be. She trusts no one. The built-in will to survive keeps her alive, barely, but overwhelmingly negative thoughts and emotions produce a risky, self-defeating, and self-destructive lifestyle. Alice shows unmistakable signs of subtle suicide, characterized by a steady descent into a black hole of self-sabotaging behavior. After thirty years of practicing this lifestyle, her prognosis is not good because her core conflicts are so well established.

In the past her counselors tried to help her attack her alcohol and drug abuse, but those are just symptoms. Alice needs to confront her core conflicts: fear of abandonment; inability to trust others; anger and self-blame for the psychological abuse she suffered as a child; and internalizing criticism from others as symbolic parental attacks on her competence and worthiness. Her case is an excellent example of the importance of what she and her counselor need to attack. Too often, psychological treatments target symptoms, a focus that ignores the deep-rooted conflict that causes the symptoms. Unfortunately, with Alice this core has been ignored so long, her personality dynamics and action patterns designed to service the root conflict have become entrenched. Replacing them will not be easy.

Happiness Might Distort Your Reality

We all hear people say, “If I win the lottery, I will be rich and happy!” Rich, maybe, happy, maybe not! Harvard psychologist Dan Gilbert notes that in one study, a year after winning the lottery, winners were less happy than were paraplegics one year after their accident. How can that be? Winning the lottery looks good and being confined to a wheelchair looks bad. For the people who live in those circumstances, however, their current estimates of happiness are seen in comparison to their earlier life and to the anticipated future. The lottery winners have learned that the anticipated happiness of winning the lottery was unrealistic; the paraplegics have learned that the challenges imposed by the injury need not be overwhelming or impossible. In both cases it was not the outcome (good luck vs. severe injury) that determined their state of happiness; rather, it was their state of mind that initially had distorted their reality. Overnight wealth can be squandered and lead to long-term problems; paraplegics can choose to find meaning and purpose in their lives through spiritual, artistic, athletic, and other types of pursuits.

            Imagine a politician telling you something over and over and over. If you have some measure of respect for that politician, you might eventually believe what he or she is telling you, even when there is no objective, reliable evidence in favor of the statement. Pure repetition distorts your perception of reality and you accept a baseless assertion as true. Imagine that a highway in your town is finally widened thanks to receiving federal funds. Your local Congressional representative is at the dedication, helping to cut the ribbon opening the highway. You are pleased because you voted for that rep. You ignore the newspaper columnist who reminds readers that your rep voted not to approve the bill providing highway funds to towns like yours across the nation. You not only ignore the truth, but you also distort your perception—my rep brought those funds to our town, and that makes me happy because I voted for that rep.

            “OK,” you might reply, “but what does all this have to do with finding happiness? What’s wrong with wanting to be happy?” Nothing is wrong with wanting to be happy, but in our example above, your happiness is fake, based on a distortion of the truth. Another problem with the happiness search is that people keep looking for it in material things—winning the lottery, getting the promotion, taking a vacation, changing jobs. Happiness does come with acquiring certain things, but it is often temporary happiness and distorts reality. What’s more tragic than a lonely, confused, dejected person of any age locked onto their computer screen desperately seeking happiness by getting something concrete, but finding instead “advice” that leads them further into a black hole of despondency, misery, and hopelessness all based on distortions of reality? Happiness should not be sought in such ways; it must result from activities you voluntarily undertake. Such actions will keep you based in reality, and help happiness emerge in your experience. Action-based happiness is long-lasting because it comes from living a life based on personal values, a life with meaning, compassion, integrity, adaptability, contentment, and purpose—in short, a life anchored in sensitivity to the needs of others.

Coping Is Not About “Me”

Last week we ended our post with these words: “The discipline of Psychology has shown again and again how an emphasis on ‘Me’ puts individuals on a self-destructive path that damages not only themselves, but also their family, friends, and acquaintances. Why would we expect anything different at the level of a society and country?”

In this age of unbridled self-preoccupation, it is easy to offend others. I once heard a politician say: “I’m offended by this, and I’m offended by my colleagues that are offended by what we’re doing.” He sounded like a frightened, self-centered person who is unable to confront a stressful situation in a constructive way. How about you? Are you regularly offended? Do you use it as an avoidance strategy? Is that how you want to go through life—mired in a swamp of avoidance and denial, unable to be flexible? Do you want to be a servant to your fears and anxieties—unguided by a system of values, with a loss of direction that makes you ambivalent about your worth?

Carl would answer those questions with a resounding “No!” A work colleague’s actions offended him but he did not avoid confronting the situation in a constructive way. Carl heard via the office grapevine that Nick, a recent hire at the company, was spreading a rumor that Carl had “padded” a travel expenses report. Nick had only been at the company for a couple of weeks, but he already was getting a reputation as a troublemaker. He always had “better ways” of doing things, and eagerly passed them on to the boss. He also seemed to enjoy spreading malicious gossip about his co-workers.

Carl was infuriated at Nick’s accusations. He could have used Nick’s upsetting and untrue accusation in an avoidance way, such as spreading derogatory rumors about Nick. Instead, in front of other colleagues, he confronted Nick and very forcefully issued an ultimatum: “Nick, I am offended by your comments that I filed false travel expenses. They are not true and I want you to give me and our colleagues standing here evidence supporting your accusation. Otherwise, I want an apology right now, and admit that you made up your accusation about me. I demand it! Evidence or apology! Right now!” Nick’s face showed he was stunned by Carl’s attack, and he proceeded to apologize, and stumbled through an excuse that he “misread some of the figures in your report.” No one present bought it, and Nick was thereafter shunned by his co-workers.

Americans are showing a lot of self-preoccupation these days, and unfortunately—unlike the appropriate actions taken by Carl—that usually leads to avoidance behavior driven by anger, hostility, and conflict. We frequently talk about the negative consequences of narcissism and self-absorption in this blog: people retreat into the comfort zone of their own needs, which makes them more dependent on others, incapable of critical thinking, and vulnerable to false messages; incoming information is molded to fit their beliefs; their sense of autonomy crumbles; their purposefulness and ability to see meaning in life fade away; and they fail to see how self-destructive their emotion-based actions have become. Frustrated and fearful of abandonment, their only recourse is to lash out—sometimes violently—at others.

The first step in coping with stress is accepting a simple fact: “I am not the primary ingredient in every recipe.” Until you put that understanding into practice, both your individual self-esteem and collective striving toward your group goals will suffer. So, let’s end our post this week like we did last week: psychological study shows how an emphasis on “Me” puts individuals on a self-sabotaging path that damages not only them, but also those around them. Why would we expect anything different in society?

The Founders Knew Their Psychology

It begins simply with three words: “We the People.” In 1787, those words announced to the world the intention of Americans to engage in self-government. The document said “We,” not “I, James Madison,” or “I, George Washington.” The document also said, “People,” and left the word unburdened by adjectives like “White,” or “Christian.” This government structure and procedures was to be managed by all “the people,” and amended whenever “the people” saw fit.

I think there’s a lot of psychology in the Preamble to the Constitution, plus a lot of coping principles that we talk about in this blog. In drawing up this document, the Founders showed humility by saying that “the people” had to agree to the document; the Founders were not going to impose it upon them as some monarch might. The Founders also showed considerable empathy and understanding of their fellow Americans. They understood their need for a productive life, liberty, and the pursuit of happiness described in Jefferson’s Declaration, and they designed a government with those needs in mind. Most importantly, though, by requiring ratification by all the states, and by putting in the document amendment procedures initiated by “the people,” they allowed “the people” to make their government in their own image – to form a government that would allow them to find purpose and meaning in their lives, to actualize themselves. I find including those processes to be an impressive application of sound psychological principles. Think about it. Psychology has always recognized the need for people to find ways to “be all I can be.” We all want to be the best we can be, to reach our full potential, to supervise and manage ourselves, to be independent and secure with who we are. The Founders are telling us, “We have a government to help actualize yourselves! Do you want it?”

Humility, empathy, and purposefulness—all must operate within the boundaries of the rights of others if our coping efforts are to succeed. If you are in it for yourself, and want to dominate others with no regard for their needs, you are destined for poor coping at best, and self-destruction at worst. Mark Leary, PhD, Professor Emeritus of Psychology and Neuroscience at Duke University, says, “After more than 40 years of research on human nature, I have come to believe that most of the serious problems people create—for themselves and for society—are rooted in excessive self-preoccupation. People think about themselves far too much, selfishly focus on what they want without sufficient regard for other people, believe that they and their group are special, and think that their beliefs are correct.”

I think the Founders of this country understood the danger of excessive self-absorption to an individual’s psychological stability, and they extrapolated this principle to a government design based on “we,” not “me.” Unfortunately, somewhere along the line, and even before the Constitution had passed, things begin to fracture in politics. In our time, that fracture has grown into serious Constitutional threats and damage. Humility and Empathy have given way to “Me”—self-absorption, greed, egotism, and a view of others not as partners in government, but as convenient steps in a ladder of glorification and deification of self. Self-preoccupation, the belief that I am superior to you, that my needs take precedence over yours, that I am special and you are unworthy of my help, will not end well. Psychology has shown again and again how an emphasis on “Me” puts individuals on a self-destructive path that damages not only themselves, but also their family, friends, and acquaintances. Why would we expect anything different at the level of a society and a country?

It’s That Time Again

Are you getting stressed out and anxious about the election? Depressed? Maybe just disgusted? It might be time to remember some important things about dealing with emotions.

Your emotions show that you care, that you are involved in our democratic process. Good for you! Also, remember that your emotions are natural states that can be a positive motivator for you. They need not be your enemy. Use emotions to motivate you to take actions that empower you. Go into “critical-thinking mode” by asking yourself some fundamental questions: Are you making a mountain out of a molehill? (“The future of humanity hinges on this election.”) Are you over-generalizing and being manipulated? (“Our entire electoral system is corrupt.”) Are you looking for logical inconsistencies between words and actions. (”FEMA is blocking disaster aid.”) from those whose pronouncements cause you worry? Do you ask yourself if you’re thinking irrationally or unrealistically (“The election will be rigged.”)? Granted, what has been said during this election can make it tough determining what may be an irrational fear (“Rapists, murderers, and drug dealers are coming by the thousands.”), but the fact remains, you must approach your emotions with some critical thinking. Think your fears through and seek out valid and reliable information.

If you have friends and acquaintances who support the candidate you do not, it helps to remember that they are entitled to their opinion, and you must respect that right. You do not, however, have to listen to them, and you have the right to tell them you do not want to talk about the election. If they persist, disengage from them. You may want to block, hide, or unfriend people from your social media accounts. But remember, those who talk loudest and longest about the wisdom and correctness of their opinion, are those who feel inadequate and insecure about the wisdom and correctness of their opinion. Psychologists call it “reaction formation.”

It might be helpful to shift your focus from the national level to your local elections. Many important issues exist at the local level, and candidates for city councils, clerkships, mayoralties, etc. are often somewhat more civil than seen on the national stage. Focusing on local contests can also help your confidence in the election process. As former Speaker of the House Tip O’Neill said, “All politics is local.” You and your neighbors, “We, the People,” are the ultimate foundation of our government.

As always, let your emotions guide you into service to others in need. Recent hurricanes provide us all with additional opportunities to help those in trouble. As a general rule of coping, however, anything you can do to venture outside yourself and perform real actions that benefit others will have positive effects on your mood and your self-esteem, plus give you a sense of purpose and meaning in what can be a very frustrating world. Research shows that giving may even alleviate depression. A focus on self is not a good strategy against depression; giving, on the other hand focuses on the needs of others, and volunteers are less likely to be depressed

Finally, it never hurts to let a little humor into life. Adlai Stevenson was Democratic candidate for president two times, losing each time to Eisenhower (1952 and 1956). But he made a good offer when he said,”I offer my opponents a bargain: if they will stop telling lies about us, I will stop telling the truth about them.”

Discovering Self-Identity and Purpose.

Note: Normally I post new entries on Friday. The probability of having power this Friday, however, is low, thanks to Milton.

Martha, now in her 50s, came to counseling struggling with loneliness. She was also having difficulty with her homosexuality. For years, she had a stable and intimate relationship with her partner, Lois. However, Lois died suddenly and Martha was emotionally devastated. She was not one to announce or otherwise display her sexual preference. The fact that she lived and worked in a small town, far from larger metropolitan areas where there would be more support from a gay/lesbian population, just added to her adjustment difficulties. Also, her age made it difficult for her to meet available gays in her own small community.

Over time, she became more and more depressed over her personal loss, as well as extremely lonely and longing for affection. She also began to show symptoms of subtle suicide. That is, she developed an ambivalence about life, deciding that she didn’t care about living; this attitude made her vulnerable to risky, careless behaviors. For instance, a same-sex neighbor became interested in her. Well into her 50s and desperate for a love connection, Martha pursued an intimate relationship despite her better judgment (the neighbor was married).

A few years later, Martha moved to a larger city and entered counseling because her married partner rejected her after more than three years of involvement. Although angry and upset over the way the relationship ended, she decided to face many of her fears, and entered counseling for help. After her initial diagnostic workup, the counselor realized that she had many strengths and positive attributes to work with, and the prognosis for achieving her goals was excellent. Counseling helped guide her into constructive ways of coping with her loneliness and depression. She realized she had to avoid self-defeating actions that could make her even more depressed and produce other negative emotional states like anxiety, frustration, and anger.

Martha learned that she had to accept her sadness and loneliness, and get better control over both her thinking and her actions. She took responsibility for those things she could control, but also accepted the fact that she was not to blame for the failed relationships. She stopped obsessing (something she could control) over the behavior of others (something she could not control), stopped feeling sorry for herself, and began to reach out and meet new people. Her social outreach helped her develop empathy for others as she became more and more engaged in gay pride initiatives. Her loneliness faded as she discovered new strengths in herself that emerged from seeing that she could be a positive influence in the lives of others. When she ended her counseling, she was not in a committed relationship, but she was developing a wide social network, and was viewed by many in the gay as someone they could turn to for support and understanding. Martha’s sense of self, and her psychological stability, grew strong and gave her a sense of purpose in life.

Can Couples Be Too Similar?

“We’re both givers so we’ll get along just fine and have a great relationship.” Maybe not. Dr. Michael Church says there are four types of givers: Self-sacrificing—passive and eager to please, they put their needs on hold to let others feel stronger and more dominant; Hypersensitive—anxious, fearful, and easy to hurt, they avoid basic responsibilities in life; Indecisive—afraid to make decisions, they rely on others and need constant reassurance they are loved; Benevolent Dictator—seeks control, but in a conventional and non-malicious manner. Church says that in some relationships with two givers, sparks can fly depending on the combination; the personalities may be too much alike to get along unless the partners make fundamental changes in their actions and expectations. The case of Andy and Gloria is an example.

            Andy and Gloria met in their late twenties and married 18 months later. Prior to meeting, neither had experienced a serious emotional relationship. Both also came from highly dysfunctional families. They described their fathers as verbally abusive and demanding, and their mothers in less than flattering terms. As each moved through their teen years, they both were eager to reach an age when they could leave home and begin independent lives.

            Andy and Gloria entered counseling complaining of a lack of intimacy in the relationship. Andy immediately stood out as a hypersensitive, dependent individual who also had narcissistic qualities. He lacked empathy, was very possessive, and could not take criticism. Gloria, on the other hand, came across as self-sacrificing, while also showing histrionic traits; she could be very dramatic and attention-seeking. She wanted to start a family and—waving her arms in the air vigorously—she complained, “It’s hard enough to get pregnant for God’s sake, and it just doesn’t help things if we only have sex once a month or even less.” Andy just shrugged his shoulders and said, “Hey, I can’t help it if I’m tired a lot and just don’t feel like it. I’m not a machine.”  

As counseling progressed, Gloria developed a variety of vague physical complaints. Despite seeing many medical specialists, there was never any diagnosis that seemed to explain her symptoms. Her therapist began to suspect that her symptoms were the result of frustration with her lifestyle and marriage. She was unhappy with the lack of marital intimacy and potential to have a child, and felt her life dreams were slowly vanishing before her eyes. When asked if she thought she would be better off out of the marriage, she said that when she suggested to Andy that they consider a separation to help them see things in a better perspective, he became very manipulative, almost childlike. Then he begged for forgiveness and quickly shifted to trying make her feel guilty for even bringing up the subject.

The more serious their marital difficulties became, the more dependent Andy became on her. He talked about finishing college and getting a better job, but made no real effort to do so. “I’m just going through a tough time, Glo. I promise you I’m going to look harder for a better job, and then we’ll have more money. I just know I can find something.”

            “I’ve heard that song and dance, Andy. When are you going to look for this great job? You keep saying you’ll do it but you don’t. Why can’t I get you to be stronger? Your empty promises are wearing me down, you know. I don’t know what to do.” Gloria was too focused on her husband’s needs and not enough on her own. She could not assert herself consistently and strongly enough with him. Consequently, she did not see too many ways to change her life. It was simply too frustrating for her to care about her wants and needs because she did not believe Andy could satisfy them.

            Andy and Gloria stopped going to counseling after several months, even though they never met their goals. They had a friendship that worked to a degree, and they were willing to stay in their no-growth relationship. The alternative would require them to make dramatic changes in their lives that would take them out of their comfort zones and produce a lot of stress, uncertainty, and more independent decisions and lifestyles. The opportunities—which they probably saw more as new stressors—for a better life associated with these challenges were not enough to motivate them towards significant change, either together or apart. Unfortunately, neither Andy nor Gloria brought out the best in the other. They each lacked both the physical and emotional chemistry needed, and were unwilling to change their relationship. They stayed together for the wrong reasons. He was extremely dependent and attached to her no matter what. She was willing to sacrifice her needs for his, even if that meant she would not be happy. We lost touch with them after they left counseling.

Coping Questions for Your Mirror

Here are some questions to ask yourself, and use to conduct what can be a penetrating self-analysis:

  1. What am I avoiding? [Sam avoids commitment because he fears rejection.]
  2. What is real in my life? [Tammy has low self-esteem, persistent feelings of worthlessness, and believes others think she’s a loser.]
  3. What is imaginary in my life? [Ralph blames his problems on his parents.]
  4. Do I fear knowledge? [Ginger believes in banning certain books in the schools and the public library.]
  5. Do I reject opinions that differ from mine? [Alex was raised to distrust others.]
  6. What are my values? [Louise believes she is entitled to have what she wants.]
  7. Are my actions consistent with my values? [Louise uses others for personal gain. She has no close friends.]
  8. Am I accountable for what’s bothering me? [Ben lives by rationalization and defensiveness.]
  9. Do I fear loneliness? [Alex has intense abandonment anxiety, yet #5 sabotages his life.]
  10. Do I talk mostly about me? [Everyone mentioned in brackets does, but they do so defensively, never humbly. What does that tell you?]
  11. Do I serve others? [No one mentioned in brackets does. What does that tell you?]

Saving the Marriage

           

Trouble stirring in your relationship? Ask yourself: “Am I giving up too much of myself?” “Is my self-identity suffering in this relationship?” “Do I need to be more assertive?” These questions are not relevant in every relationship, but they are with Jen and Bob, a couple who sought marital counseling when Jen learned of Bob’s affair. They had been married for 13 years and had three young children. Everyone in the family was physically healthy, and Jen and Bob worked as professionals; money was not a problem. They had a history of good times together. Sure, there were strains and stressors: kids, house, and their jobs, but nothing extreme or unmanageable. What happened?

Initially, counseling involved looking into the dynamics of their lives before marriage. Bob described his father—the only deceased parent of the four—as abusive and strict. Bob was an only child, so he got the brunt of punishment and demands doled out regularly by his father. Bob described his mother as nurturing, supportive, and protective. She was, however, absent a lot because of her professional employment. Bob developed into a hypersensitive individual with some rebellious traits. The latter was due to some suppressed anger toward authority (Dad), and uncertainty about how to express the anger because of fear of retaliation. “Dad really intimated me,” said Bob. “I was angry at him and resented him a lot, but I was really scared of him. He could really dish out the punishment.”

            Jen dad was the nurturing and sensitive one in her family, whereas her mom was supportive but “tough.” Jen’s family life encouraged her to develop into a hard-working, self-sacrificing person who was open and forgiving, traits that were not dominant in Bob. Jen also became far less oppositional than her husband; Bob would be more likely to challenge and disagree with Jen’s decisions than Jen would be with Bob’s. Jen leaned more toward conciliation and compromise.

            For the first decade of marriage, their relationship was solid, although Bob sometimes was too uncompromising and self-centered. Jen brushed it aside as not worth worrying about. (denial and avoidance.) Jen says, “I remember thinking that he should be a little more considerate and see how I felt about things. But he would just charge ahead and do whatever he wanted to do without discussing it with me. I remember being a little disappointed and frustrated, but I just chalked it up to a quirk of his. No big deal, I figured.”

            On the surface Bob was a great guy who would do almost anything for anyone. Inside, however, there was a rebel lurking to express itself, and here we come to the crucial elements in the dynamics of this marriage: Jen was excessively sacrificing for the sake of the family; Bob, however, was tough in dealings with his family—just as his father had been—and he saved his nurturing, supportive side for those outside his family. He could not say “no” to friends, co-workers, relatives, and even the woman with whom he had the affair. The woman was aggressive in pursuing him, and he finally gave in. Bob was a patsy outside the home.  

            During counseling Bob admitted to his anger over the emotional deprivation he suffered at the hands of his father. He confessed he never really felt he was good enough for anyone, feelings that began with interactions with his dad. He felt he needed to keep trying to prove to everyone he was lovable. At an intellectual level, he knew such a goal was irrational but emotionally he was driven in this direction. Jen, meanwhile, was paying most of her attention to the kids. She had let the marriage slip a bit by giving insufficient attention to Bob, thereby awakening some of the emotional deprivation issues he had from his childhood. Jen’s lack of attention also meant that Bob was doing pretty much whatever he wanted without ever being questioned about it.

            Eventually, Bob achieved some insight into the origin of his problems, and realized that his marriage showed he was indeed quite lovable. He also got a better handle on his underlying resentment for rules and conventions that his father had beat into him. “These insights allowed me to start concentrating on my marriage more, and the affair less,” Bob observed later. The other woman concocted a story that she was pregnant with Bob’s child but miscarried. Bob said, “It took me a long time to understand how pathological this woman was, and to finally accept her crazy story as a lie. It wasn’t easy to reach that point, though.”

            Jen stood firm and supported Bob’s counseling and his efforts to produce changes in himself. “OK, sure, a lot of women would have told Bob to go to hell,” Jen says. “To me, though, holding the family together came first. Sure, I was upset and mad, but I couldn’t let those feelings get in the way of saving the family. I saw the affair as more Bob’s lust, not love of that woman, and that gave me something to work with.” After many sessions, Bob learned how to genuinely receive love from his wife. More importantly, he learned that he did not have to continuously prove his worth, and fill himself with approval, status, and recognition from others, especially those outside his family and work life. He came to realize that the extramarital affair was not simply a mid-life crisis, but was a failed attempt to prove he was lovable and needed. Both Bob and Jen pledged more quality time to one another. Bob was finally growing beyond his childhood demons, which allowed Jen to do the same, although her demons were much milder in degree.

Youth Mental Health in a Psychologized society

Psychologists and other mental professionals have expressed concern over what they see as a mental health crisis in teens and young adults. Some psychologists recommend regular anxiety screenings for youth ages 8 to 18, and regular depression screenings for ages 12 to 18. Recent clinical studies with teens have focused on anxiety, bipolar disorder, depression, eating disorders, post-traumatic stress disorder, addiction, obsessive-compulsive disorder, and suicide. Mental health workers note pandemic social isolation and the academic disruption children and teens faced: caregivers died or lost their job from Covid, and kids were victims of physical or emotional abuse at home; there are ongoing social media tensions, school violence, and climate worries, plus the usual adolescent hormonal chaos. Is it all too much for many youngsters?

I was a teenager from 1957 (age 13) to 1964 (age 20). As I recall, I had two main worries: keeping up with schoolwork, and girls. The former was manageable as long as I was willing to put in the time and effort; the latter was a losing battle. Girls remained a constant source of frustration, bewilderment, and rejection. In college my stressors were classes, grades, and girls, who remained a source of frustration, bewilderment, and rejection. I was in college when the Cuban missile crisis happened, but no one really believed the world was going to end. The calculus test was still on tap for tomorrow. Kennedy was assassinated but no one feared for the Republic; Johnson was sworn in within hours and life went on. There were rumblings in Southern cities and I believed in Dr. King’s message, but at the end of the day, I was White. No problem. There were no smart phones, no internet, no school shootings, no attacks on the Capitol.

I have no doubt that the stressors for teens today are more intense than in my day. Being bullied on the playground is one thing; bullied on social media is tougher on the victim. Going to class to take a test is one thing, but wondering if someone will show up with an assault rifle is quite another; taking No-Doz to help with studying all night is one thing, but scoring MDMA, ecstasy, cloud nine, or shrooms goes to another level. But there’s another difference between yesterday and today, a difference that’s overlooked but that I think makes today more stressful: Teens today live in a “psychologized” society; I did not.

What’s a psychologized society? It’s a society where we are sensitized to—alert to, vigilant about— psychological disorders; it’s a society where people believe every unexpected event, every challenge to one’s plans, every conflict, every “OMG” intrusion into one’s world is going to be psychologically debilitating; it’s a society where words like, “You need counseling,” “You’re probably bipolar,” and, “You have anxiety issues from PTSD,” are commonplace; it’s a society where we convince teens that because they have “mental issues,” that they are abnormal and afflicted with a psychological disorder.

More than once, I recall my parents saying, “You’re getting a little big for your britches, young man. It’s time for you to show some respect for your elders.” I never heard them say, “You have oppositional defiant disorder; we’ll have you checked by a counselor.” Today, however, when teens hear the “counselor” word—and they hear it often—they immediately think, “Counselor? OMG, I’m mentally ill!” And downward they spiral from there. That’s what happens to teens who live in a psychologized society in 2024. I saw a recent newspaper article about the importance of choosing a college major as soon as possible because, “Imagine the emotional stress of having to find a new major and career path one or two years shy of getting your college degree.” I taught college for 41 years (1970-2011) and I believe that the statement’s overemphasis on “emotional stress” is misguided. I advised scores of students who wanted to change their major and their career path. In 1961 I had a college friend who had a first-year gpa of 1.7. [You need a cumulative 2.0 to graduate.] He decided to change his major. His second-year gpa was 2.3 and things turned around by his junior year. He was behind but he caught up with a couple of summer courses. But you know what? Never did anyone—no friend, no parent, no teacher, no advisor—say to him, “You’re going to be under a lot of emotional stress with this change of major and you should go to the Counseling Center for help in dealing with the anxiety.” That just wasn’t our culture in the 1960s.

The Diagnostic and Statistical Manual of Mental Disorders (5th edition, published in 2013) contains nearly 300 disorders. The first edition of this manual (published in 1952) contained 102 disorders. There can be little doubt that the manner of classifying mental disorders has changed and been significantly refined in the last 70 years. The problem is, these refinements have led to a greater number of “disorders,” and terms like bipolar, PTSD, anxiety disorders, obsessive-compulsive, eating disorders, and addiction have become commonplace. The result is that impressionable teens integrate disorders into their developing self-concept, and fall victim to believing that they are abnormal. This self-preoccupation and self-sabotaging process is helped along by indulgent, guilt-ridden parents, and their kids develop a sense of entitlement—“treat me gently; I’m bipolar”—that they wear for all to see. We are seeing in real time the consequences of this psychologizing process in our society as support services struggle to keep up with increasing numbers of youngsters who believe they are “mentally ill.”  Of course, the internet, school violence, and climate worries are partly to blame. But so is the psychologized society we have created. Maybe, just maybe, instead of playing the mental disorder card every time a young person strays, adults should convey a message like this to them: “The world is a tough place and has some harsh standards. But, that’s reality, and I know that you can meet those standards; I have faith in your ability to do that, and I’m here to help out when you need it.”